Managing Chronic Obstructive Pulmonary Disease

282 Pages·2007·3.195 MB·English

by  Laura Blackler, Christine Jones, Caroline Mooney

Managing Chronic
Obstructive
Pulmonary Disease
Edited by
LAURA BLACKLER RN, BSc, MSc
Guy’s and St Thomas’ Hospital, London
CHRISTINE JONES RN, Clinical Nurse Specialist – Respiratory
King’s College Hospital, London
CAROLINE MOONEY RN, Community Nurse Specialist –
Respiratory
Luton Treatment Centre, Luton
John Wiley & Sons, Ltd
Managing Chronic
Obstructive
Pulmonary Disease
Managing Chronic
Obstructive
Pulmonary Disease
Edited by
LAURA BLACKLER RN, BSc, MSc
Guy’s and St Thomas’ Hospital, London
CHRISTINE JONES RN, Clinical Nurse Specialist – Respiratory
King’s College Hospital, London
CAROLINE MOONEY RN, Community Nurse Specialist –
Respiratory
Luton Treatment Centre, Luton
John Wiley & Sons, Ltd
Copyright © 2007 John Wiley & Sons Ltd
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Library of Congress Cataloging-in-Publication Data
Managing chronic obstructive pulmonary disease / [edited by] Laura Blackler, Christine Jones,
Caroline Mooney.
p. ; cm.
Includes bibliographical references.
ISBN 978-0-470-02718-9 (alk. paper)
1. Lungs–Diseases, Obstructive. I. Blackler, Laura. II. Jones, Christine, RN. III. Mooney,
Caroline.
[DNLM: 1. Pulmonary Disease, Chronic Obstructive – nursing. 2. Pulmonary Disease,
Chronic Obstructive – therapy. 3. Quality of Life. 4. Self Care. WY 163 M266 2007]
RC776.O3M366 2007
616.2'4 – dc22
2007011290
A catalogue record for this book is available from the British Library
ISBN 13: 978-0-470-02718-9
Typeset in 10/12 pt Times by SNP Best-set Typesetter Ltd, Hong Kong
Printed and bound in Great Britain by TJ International Ltd, Padstow, Cornwall
This book is printed on acid-free paper responsibly manufactured from sustainable forestry in
which at least two trees are planted for each one used for paper production.
Contents
List of Contributors vii
Preface ix
Introduction xi
Laura Blackler, Christine Jones and Caroline Mooney
1 Pathophysiology 1
Sunny Kaul
2 Diagnosing COPD 13
William D.C. Man
3 Symptom Management 27
3.1 Pharmacological Management 27
Patricia Yerbury, Paul Bains and Vijay A. Selvan
3.2 Adherence/Concordance 38
Caroline Mooney
3.3 Nebulised Therapy at Home 41
Christine Jones
3.4 Long-term Oxygen Therapy 49
Laura Blackler
3.5 Surgical Interventions 56
Andrew Menzies-Gow
4 Smoking Cessation 65
Sunny Kaul
5 Pulmonary Rehabilitation 85
Amy Grant and Lauren Moore
vi CONTENTS
6 Quality of Life 113
6.1 Fatigue Management 113
Tanya Navarro
6.2 Nutrition and Healthy Eating 120
Richard C. Wilson
6.3 Continence 124
Sue Foxley
6.4 Sleep 130
Laura Blackler
6.5 Travel and Holidays 135
Caroline Mooney
6.6 Vaccinations 140
Caroline Mooney
6.7 Sexuality 146
Christine Jones
7 Psychological Needs and Interventions 157
Linda Fisher
8 Management of COPD in the Community 175
Patrick White
9 Management of Acute Exacerbations in Hospital 191
Jacqui Fenton
10 Non-Invasive Ventilation 207
Tracey Mathieson
11 End-of-Life Care 219
Fliss Murtagh, Mary Preston and Claudia Bausewein
12 The Future for the Care and Management of Individuals
with COPD 237
Laura Blackler, Caroline Mooney and Christine Jones
Glossary 243
Appendix Useful Organisations 253
Index 261
List of Contributors
Paul Bains, Lead Pharmacist, Hammersmith Hospital, NHS Trust, London
Claudia Bausewein, The Cicely Saunders Foundation Research Training
Fellow, King’s College London School of Medicine, London, and Inter-
disciplinary Centre for Palliative Medicine, University Hospital Munich
Jacqui Fenton, Senior Respiratory Clinical Nurse, King’s College Hospital,
London
Linda Fisher, Dept of Health Training Fellow, Cognive Behaviour Therapist,
Dept of Psychological Medicine, King’s College Hospital, London
Sue Foxley, Nurse Consultant – Continence, King’s College Hospital, London
Amy Grant, Senior Respiratory Physiotherapist, Lambeth and Southwark
Pulmonary Rehabilitation Team
Sunny Kaul, lecturer in Palliative Care, King’s College Hospital, London
William D.C. Man, Specialist Registrar in Respiratory Medicine, Royal
Brompton Hospital
Tracey Mathieson, Lead Physiotherapist, King’s College Hospital, London
Andrew Menzies-Gow, Consultant in Respiratory Medicine, Royal Brompton
Hospital
Lauren Moore, Senior Respiratory Physiotherapist, Lambeth and Southwark
Pulmonary Rehabilitation Team
Fliss Murtagh, Research Training Fellow, King’s College Hospital, London
Tanya Navarro, Occupational Therapist, King’s College Hospital, London
viii LIST OF CONTRIBUTORS
Mary Preston, Clinical Nurse Specialist – Palliative Care, King’s College
Hospital, London
Vijay A. Selvan, Medical Care Group and A&E Link Pharmacist, King’s
College Hospital, London
Patrick White, GP and Clinical Senior Lecturer, King’s College School of
Medicine, London
Richard C. Wilson, Senior Dietician, King’s College Hospital, London
Patricia Yerbury, Pharmacy Team Leader for General Medicine Care Group,
King’s College Hospital, London
Preface
COPD is on the increase worldwide, and it is predicted that by 2020, it will be
the third leading cause of death. It has been recognised that there is a need to
improve the care offered, to ensure an early diagnosis and raise the public profi le
of the disease. Health care providers are at the forefront of this, and can have a
huge impact on improving an individual’s quality of life; through health educa-
tion, early diagnosis, and better management through all stages of the disease.
COPD is a chronic, progressive debilitating disease, which not only affects
the individual, but also has consequences for family members. These individu-
als come into frequent contact with health care providers in both primary
and secondary care sectors. Therefore it is important that the care given is
evidence-based and seamless, supporting the individual and their family
through the various stages of the disease. To promote this, the NICE guidelines
Management of Chronic Obstructive Pulmonary Disease in Adults in Primary
and Secondary Care (2004) will be referred to throughout the book.
This book is written for nurses and allied health professionals caring for
patients with COPD at all stages of their disease. It is about the patient’s journey
including: diagnosis, management of acute episodes, living with the disease, and
end of life issues. The aim is to develop nurses’ and allied health care profes-
sionals’ knowledge and skills in caring for the individual with COPD.
The book takes the reader on a journey from initial diagnosis, through to end
of life. The opening chapter provides the reader with an insight into the growth
of the disease, the pathophysiology of COPD, and interventions that can have
an impact on its progression. It is written to follow the patients’ journey using
an MDT approach that can be utilised by all health care professionals involved
in caring for this group of patients. Throughout the book, direct quotes from
patients with COPD are highlighted in bold. It is an opportunity to provide an
insight into this debilitative disease; focusing upon the psychological, physical
and social components, and uses quotes from patients to highlight these.
Contributions to the book have been obtained from different health care
specialists who care for this group of patients. Each chapter is evidence-based
and fully referenced and there is a glossary at the end of the book which
explains the terms used throughout the book. The term is indicated in bold on
its fi rst occurrence.
Introduction
LAURA BLACKLER
Guy’s and St Thomas’ Hospital, London
CHRISTINE JONES
King’s College Hospital, London
CAROLINE MOONEY
Luton Treatment Centre, Luton
FACTS AND FIGURES
EPIDEMIOLOGY
Chronic obstructive pulmonary disease (COPD) is a growing problem through-
out the world and in the report Global Burden of Disease (2006) undertaken
for the World Health Organisation (WHO) and the World Bank it was esti-
mated that the prevalence of COPD was:
11.6/1000 – men
8.77/1000 – women
It was estimated that there were 2.75 million deaths as a result of COPD;
however, this could well be underestimated due to COPD being seen as a
contributory factor rather than the primary cause of death. WHO have esti-
mated that, in 2005, approximately 80 million people had moderate to severe
COPD and there were 3 million deaths.
In the UK, the British Thoracic Society commissioned a report Burden of
Lung Disease (Gupta & Limb 2006) and this showed that, in 2004, there
were over 27,000 deaths due to COPD, there is an almost 50 : 50 split between
men and women. This is 23 per cent of all deaths due to respiratory disease,
and, overall, 20 per cent of all deaths in 2004 were due to respiratory
disease.
COST OF COPD IN THE UK
There is a signifi cant cost to the NHS of the 845,000 inpatient admissions with
respiratory diseases during 2004/2005 and this represents 7 per cent of all
admissions. COPD accounted for nearly 10 per cent of all hospital bed days –
5.2 million bed days were used for patients with respiratory disease and COPD
accounted for 21 per cent of these.